PROBLEMS OF PSYCHIATRY PRACTICE IN PRISONS - ZURICH MODEL

• NCJ Number: 66267
• Journal: NERVENARZT Volume: 50 Issue: 6 Dated: (1979) Pages: 360-365
• Author(s): R BINSWANGER
• Date Published: 1979
• Length: 6 pages
• Corporate Author: Springer-Verlag
• Publication Format: Article
• Publication Type: Program Description (Model)
• Language: German
• Country: West Germany (Former)

Annotation

THE PROBLEMS OF PROVIDING INMATES WITH PSYCHIATRIC SERVICES ARE DISCUSSED, AND THE SOLUTIONS OF THE ZURICH MODEL (SWITZERLAND) ARE PRESENTED.

Abstract

IN PROVIDING MEANINGFUL PSYCHIATRIC TREATMENT FOR INMATES, PSYCHIATRISTS FACE NUMEROUS PROBLEMS: CONFLICTING OBLIGATIONS TOWARDS THE PATIENT AND THE CRIMINAL JUSTICE SYSTEM, EXAGGERATED INMATE EXPECTATIONS IN THE SUCCESS OF THERAPY, THE DEMANDS OF THE CORRECTIONAL INSTITUTIONS, AND, ABOVE ALL, THE UNTHERAPEUTIC ENVIRONMENT OF THE CORRECTIONAL FACILITY. THE ZURICH MODEL OF PSYCHIATRIC SERVICES, IMPLEMENTED IN TWO SWISS CORRECTIONAL FACILITIES, IS BASED ON (1) PSYCHIATRIC TREATMENT OF PRISONERS THROUGH PART-TIME PSYCHIATRISTS WHO ALSO WORK WITH REGULAR PATIENTS AT THE ZURICH UNIVERSITY HOSPITAL, (2) CLOSE INTERDISCIPLINARY COLLABORATION WITH PRISON MEDICAL DOCTORS WHO ARE ALSO PART-TIME EMPLOYEES OF THE HOSPITAL, AND (3) A SEPARATE PSYCHIATRIC SERVICE (MADE UP OF DIFFERENT STAFF) WHICH FULFILLS THE OBLIGATIONS TOWARDS THE CRIMINAL JUSTICE SYSTEM (E.G., EXPERT REPORTS ON INMATES, PREDICTIONS). UNDER THE ZURICH CONCEPT, PSYCHIATRIC TREATMENT IS STRICTLY VOLUNTARY AND HAS NO INFLUENCE ON AN INMATE'S EVALUATION; TO INSURE THIS VOLUNTARINESS, PSYCHIATRISTS REFRAIN FROM FURNISHING ANY PREDICTIONS OR EXPERT REPORTS ON THEIR PATIENTS TO THE CRIMINAL JUSTICE SYSTEM. PRISONERS ARE ACCEPTED FOR TREATMENT ACCORDING TO MOTIVATION, THE WILLINGNESS TO COMMUNICATE, AND EMOTIONAL ACCESSIBILITY RATHER THAN DIAGNOSIS. GREAT EFFORT IS MADE TO KEEP PSYCHIATRIC AND MEDICAL SERVICES INDEPENDENT FROM THE PRISON ADMINISTRATION SINCE THE GOALS OF EACH ARE ESSENTIALLY DIFFERENT: WHILE THE THERAPISTS' PRIMARY OBLIGATION IS TOWARDS PATIENTS, THE PRISON ADMINISTRATION'S CHIEF CONCERN IS THE SMOOTH FUNCTIONING OF THE PRISON ROUTINE. WHILE THERAPISTS STRIVE FOR LONG-TERM BEHAVIORAL CHANGES, CORRECTIONAL PERSONNEL ARE INTERESTED IN QUICK SUCCESS. THE ARTICLE CONTAINS A BIBLIOGRAPHY. --IN GERMAN. (SAJ)